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June 13, 1966

Prophylactic Surgery For Cancer of the Colon

JAMA. 1966;196(11):1027-1028. doi:10.1001/jama.1966.03100240161057

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To the Editor:—  Following publication of the paper by Claude E. Welch on prophylactic surgery for cancer of the colon and rectum (195:728, 1966) I have received a number of inquiries about this complex problem. Welch answered his own question "Should polyps of the large bowel, even if histologically benign, be removed to prevent the later development of cancer within them?" in the affirmative. Some of Welch's reported cancers in adenomas, upon restudy years later, were either totally benign or polypoid cancers (New Eng J Med267: 469, 1962). Similar conclusions based on a study of clinical and pathological material, were reported before by the St. Louis group of researchers (Ann Surg148:682, 1958).Welch, in support of his belief in transformation from benign into malignant states, referred to a recent study (Surg Forum14:137, 1963) which was based on repeated surface cytological examinations on 213 "benign

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